Medicine and Health Sciences Commons^™

How Unstructured Data From The Data Warehouse Can Be Used With Machine Learning And Visualization To Develop Novel Medical Technologies, Alfred A. Cecchetti

Faculty Research Day

Machine Learning (ML) can accurately classify and accurately predict disease as well as other medical events.

Device Programming, especially smartphone applications, can provide new ways to acquire, transport, store, process, and secure personalized patient data to deliver meaningful results.

Telehealth In Critical Care: Quality And Cost Outcomes, Michael Robbie, Stephanie Cole, Bukola Abodunde, Alberto Coustasse

Faculty Research Day

The purpose of this study was to assess the potential for the implementation of telehealth in the ICU to determine its impact on quality of care and overall healthcare costs. The primary hypothesis of this study was that telehealth would be linked with lower ICU LOS and hospital mortality rates among critically ill patients.

Post-Implementation Analysis Of The Impact Of Intravenous Automation Systems On Health-System Pharmacy Operations, Craig Kimble, Ken Maxik, Chris Booth, Michael Rudolph, Kim Broedel-Zaugg

Faculty Research Day

We have all seen the reports on the news about issues related to IV rooms and IV room compounding. Many health-system pharmacies have implemented, or are considering some form of intravenous (IV) automation and/ or compounding system in their clean rooms to reduce pharmacy errors and improve accuracy, productivity, and workflow. Manufacturers tout that automated systems, used appropriately, aid in reducing errors from reaching patients. Additionally, IV admixture automation is one of the most recent areas where technology has been added to pharmacy workflow.

Patient Communication With Their General Practice Physicians: Does Age Matter?, William K. Willis, Marcy Butler, Ashish Chandra

Faculty Research Day

We examine the difference in outcomes between various age groups and their communication with their General Practitioner.

Telehealth In Critical Care: Quality And Cost Outcomes, Stephanie Cole, Michael Robie, Bukola Abodunde, Alberto Coustasse

Management Faculty Research

As the population of the United States has continued to age, there has been an increase in usage and Hospital Length of Stay (LOS) costs of Intensive Care Unit (ICU) beds. In the early 2000s, it was determined there would be a shortage of all ICU providers within the next decade due to the increased need for critical care for the aging generation. Around this time, the Leapfrog Group was formed to demand that hospitals improve quality and decrease cost. Utilization of telehealth in the ICU was a possible alternative, which had a positive impact on both clinical and financial …

Ending The Silence: Utilizing Personal Experiences To Enhance A Library Mental Health Initiative, Sabrina Thomas, Kacy J. Lovelace

Librarian Research

This article summarizes a panel presentation given at the American Library Association Annual Conference in Washington D.C. ( June 22, 2019). The panel consisted of Sabrina Thomas, research and instruction librarian at Marshall University; Leah Tolliver, director of wellness programs and the Women’s and Gender Center at Marshall University; C. Michelle Alford, senior library IT consultant at Marshall University; and Kacy Lovelace, research and student success librarian at Marshall University. Tenikka Phillips, EAP coordinator at Cabell Huntington Hospital, worked extensively on the project but was unable to take part in the panel presentation. The following is a conversation between Sabrina …

Combining Efforts: Libraries As Mental Health Safe Spaces, Sabrina Thomas, Kacy J. Lovelace

Librarian Research

In the face of seemingly insurmountable, persisting problems, what is one thing that you could do to lift that burden in your own space, in your own building, or on your own walls? This defining question led to the creation of Marshall University (MU) Libraries Mental Health Initiative. The initiative began with an art exhibition titled: “Don’t Call Me Crazy: Resiliency through Art.” The goal of this exhibition was to encourage students, faculty, and staff to create artwork informed by mental health or to help process their own mental health. With more than 30 artists and 50 pieces filling the …

Accessible Design In Rural Health Care: Usability Profile Of Outpatient Health Care Facilities In Rural West Virginia, Jordan Elliott Miller, Chris Haddox

Marshall Journal of Medicine

The purpose of this research is to better understand the physical and environmental features of outpatient healthcare facilities that act as barriers to healthcare access in rural West Virginia and factors that contribute to non-compliance with the ADA. The research aims to explore the prevalence of barriers in rural West Virginia health facilities and the relationship between building characteristics (like year of construction and original purpose) and accessibility. The researcher evaluated ten rural outpatient member-sites of the West Virginia Practice-Based Research Network using the Outpatient Health Care Usability Profile to measure essential features for a facility to be considered ‘usable’. …

Statistical Methods Useful In Clinical Simulation And Medical Education Scholarship, Zuber D. Mulla, J. Hector Aranda, Donovan Rojas, Sanja Kupesic Plavsic

Marshall Journal of Medicine

The objective of this paper is to introduce selected statistical and epidemiologic topics that are of interest to interdisciplinary teams of healthcare quality professionals, educators, technical staff, and researchers who participate in clinical simulation scholarship. Four research vignettes in the setting of a hypothetical clinical simulation training workshop are presented. The first vignette illustrates the utility of exact logistic regression when analyzing a small dataset. The second underscores the importance of using an appropriate method to account for the repeated measurement of an outcome. The third illustrates the use of the intraclass correlation coefficient to measure inter-rater reliability. The final …

Cavernous Sinus Thrombosis Complicated By Carotid Artery Occlusion: A Case Report, Faisal Taleb, Seraj S. Ajaj, Abdussalam Abograra, Ali Eldeeb

Marshall Journal of Medicine

Cavernous sinus thrombosis (CST) is a fatal phenomenon that requires clinical suspicion and emergent imaging for correct diagnosis. . However, only a few authors reported severe involvement of the internal carotid artery (ICA). Here we report an 11 year old girl diagnosed with Cavernous sinus thrombosis complicated by left internal carotid artery occlusion.

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Diabetic Muscle Infarction: A Rare End-Organ Vascular Complication Of Diabetes, Callie Seaman, Michael Amos, Adam M. Franks, Asher Sexton, Kimberly Mcclelland, Erika M. Harris

Marshall Journal of Medicine

Diabetic muscle infarction (DMI) is a rare microvascular complication of spontaneous ischemic necrosis of skeletal muscle in patients with poorly controlled diabetes. We herein describe the case of a 26-year-old woman with a history of type I diabetes and accompanying diabetic microvascular complications of neuropathy, nephropathy and retinopathy, who presented with sudden onset of swelling and sharp pain in her bilateral thighs. T2-weighted MRI imaging revealed subcutaneous edema and sub-fascial, hyper-intense enhancement of proximal thigh musculature. DMI has a relatively non-specific clinical presentation; therefore, physician awareness is key for early diagnosis, as aggressive management has been associated with poor patient …

Artificial Intelligence And The Challenge For Rural Medicine, James Denvir

Marshall Journal of Medicine

Recent advances in artificial intelligence, machine learning, and deep learning are beginning to have an impact on everyday experiences, from natural language processing used in automated telephone call centers to semi-autonomous vehicles. These techniques have also been applied to medical care. In this editorial we discuss applications of AI to medicine and argue for a proactive approach to include rural medicine in this paradigm shift.

Pigmentary And Other Dermatologic Manifestations Of Minocycline: A Reminder Of Adverse Effects, Kayla Rodriguez, Courtney Wellman, Adam M. Franks, Kimberly Mcclelland, Tammy Bannister

Marshall Journal of Medicine

The applications of the tetracycline class of antibiotics extends beyond their antimicrobial activity to anti-inflammatory, immunosuppressive and neuroprotective applications making it a commonly used class of medication. Minocycline, a second generation tetracycline, has inherent characteristics that improve absorption and distribution. These benefits promote even more wide spread use. This familiarity of usage breeds prescriptive complacency toward the dermatologic complications including hyperpigmentation. The following case explores these adverse manifestations of Minocycline use.

Acute Diagnosis Of Wilson’S Disease In A Teenage Patient, Sarah Irvin, Ryan Mccarthy

Marshall Journal of Medicine

Wilson’s Disease, a rare autosomal recessive genetic disease, is caused by a mutation in the ATP7B enzyme gene. Without this enzyme, copper builds up in the brain, liver, and cornea causing a multitude of symptoms. It is important to consider Wilson’s disease because the prognosis is dependent on timely diagnosis. This is an interesting case of a 19-year-old male who presented with suicidal thoughts and rapid weight loss. After many months and an extensive work-up, Wilson’s Disease was diagnosed. Due to his rapid decline, he was transferred to a larger university healthcare center where he is currently enrolled in clinical …

Is Napping A Good Thing?, Sammar Atassi

Marshall Journal of Medicine

This article aims to explore new findings in research in the relationship between sleep disorders and dementia. The new research questions the glymphatic system's role in clearing the toxic proteins from the brain during sleep.

Case Reports: Add Value Beyond The Impact Factor, Darshana T. Shah

Marshall Journal of Medicine

No abstract provided.

The 340b Program, Contract Pharmacies, Hospitals, And Patients: An Evolving Relationship Impacting Health Care Delivery, Morgan Ruley, Morgan Belcher, Hannah Sayre, Alberto Coustasse

Management Faculty Research

The 340B Drug Pricing Program, created by Congress in 1992 through the Veterans Health Care Act, has provided discounted drug prices to hospitals and other health care organizations serving a wide population of low-income patients. Some 340B programs use contract pharmacies, an arrangement whereby the hospital or health care organization signs a contract directly with a pharmacy to provide covered pharmacy services at discounted prices. The federal 340B Drug Pricing Program has provided access to reduced price prescription drugs to more than 35 000 individual health care facilities and sites certified by the US Department of Health and Human Services, …

A Challenging Case Of Spontaneous Bacterial Empyema In A Cirrhotic Patient, Saad Emhmed Ali, Olalekan Akanbi, Macy Godman, Mohanad Soliman, Wesam M. Frandah, Karim Benrajab

Internal Medicine

Spontaneous Bacterial Empyema (SBEM) is distinguished as a primary infection of pre-existing hepatic hydrothorax in the absence of cardiopulmonary or pleural disease. It is an under-recognized complication of cirrhosis and is associated with high morbidity and mortality. The diagnosis requires chest imaging to rule out underlying pneumonia as an etiology; a diagnostic thoracentesis is crucial to make the diagnosis and should be obtained in any patient with pleural effusion and evidence of infection. Expeditious administration of antibiotics is essential to ameliorate the outcome. We present an interesting case of spontaneous bacterial empyema in a cirrhotic patient with hepatic hydrothorax.

Geriatric Hepatology: The Hepatic Diseases Of The Elderly And Liver Transplant, Shima Ghavimi, Hamed Azimi, Neel Patel, Oleg Shulik

Internal Medicine

Introduction: With the aging US population, chronic liver diseases are becoming more commonly diagnosed in the geriatric population. Advanced age leads to changes in liver blood flow, volume, morphology and normal physiology. This predisposes elderly patients to develop certain chronic liver diseases. Also, the clinical course and management differ in an older patient when compared to a younger patient. Some causes of chronic liver disease in the geriatric population include Hepatitis A, B, C, Non-Alcoholic Fatty liver disease, prolonged alcohol use and inflammation. Many chronic liver diseases are characterized by a slow, indolent course of progression with non-specific symptoms and …

Duodenal Variceal Bleeding With Large Spss Treated With Transjugular Intrahepatic Portosystemic Shunt And Embolization: A Case Report, Rohit Anand, Saad Emhmed Ali, Driss Raissi, Wesam M. Frandah

Internal Medicine

Background: Duodenal variceal bleeding is a rare cause of gastrointestinal bleeding. The most common site is the duodenal bulb. It is usually detected endoscopically but it can be very challenging to diagnose if it is located distal to the second part of duodenum. The pre- transjugular intrahepatic portosystemic shunt (TIPS) presence of SPSS was found to be associated with an increased risk of early morbidity and mortality after TIPS placement. Case Summary: A 43-year-old cirrhotic male presented with melena for three days. Upper endoscopy was performed and showed active blood oozing from the distal duodenum concerning for ectopic duodenal varix. …

How Acceptable Is The Hiv/Aids Self-Testing Among Women Attending Immunization Clinics In Effurun, Southern Nigeria, Wasiu Olalekan Adebimpe, Doraebikeme Ebikeme, Olubukunola Omobuwa, Edward Oladejo

Marshall Journal of Medicine

HIV testing remains the gateway to HIV/AIDS prevention, treatment, care and support interventions. In Nigeria, a significant proportion of the populations do not know their HIV status. HIV self-testing done without the help of a healthcare provider could remove identified barriers to HIV testing, and close gaps in HIV treatment and prevention cascades. This study set out to assess the knowledge and acceptability of hiv self-testing (HIVST) among women of child bearing age attending immunization clinics in Effurun, Nigeria. A descriptive, cross-sectional study was conducted among 357 women of child-bearing age selected using multistage sampling technique. Research instrument used was …

Prasugrel Inappropriate Use In Patients Post-Percutaneous Coronary Intervention (Pci). A Single Center Study, Ahmed Amro, Kanaan Mansoor, Mohammad Amro, Amal Sobeih, Obadah Aqtash, Hisham Hirzallah, Alaa Gabi, Madhulika Urella, Waseem Ahmed, Sandra Shenouda, Dr. Rameez Sayyed, Md

Marshall Journal of Medicine

Prasugrel is a thienopyridine that was approved by the US Food and Drug Administration (FDA) in combination with aspirin for the reduction of thrombotic events as well as stent thrombosis in patients with ACS who undergo PCI. This retrospective study aims to assess the frequency of inappropriate use of prasugrel and to emphasize that prasugrel still needs more attention as inappropriate use may result in significant morbidity.

Intralesional Corticosteroids For Long-Term Control Of Primary Cutaneous Marginal Zone Lymphoma Without Systemic Involvement, Pragya Tiwari, John Hall, Anand Rajpara, Carol Stanford, Daniel Aires

Marshall Journal of Medicine

Primary cutaneous marginal zone lymphoma (PCMZL) is a B cell lymphoma with a very low metastatic rate. Radiographic monitoring for internal involvement may be indicated initially. Favored treatments include radiation and excision. Radiation has high risk of local recurrence. Excision carries risk of infection and scarring. We report successful long-term treatment of recurrent PCMZL via intralesional steroid injections into new lesions as they arose. This was preferred by the patient over her prior radiation and surgical treatments. Intralesional steroids have the advantages of being simple and well tolerated, without exposure to ionizing radiation, or to the infection and scarring associated …

Availability Of Long Acting Reversible Contraceptives For Adolescents In Urban Vs Rural West Virginia Counties, Brooke Andrews, Cameron Ross, Jennie L. Yoost

Marshall Journal of Medicine

The study objective was to evaluate long acting reversible contraceptive (LARC) method availability and access for adolescents in rural and urban counties in West Virginia (WV). A cross-sectional survey of Title X family planning providers throughout WV was conducted from January 2016-July 2017. This survey was sent to 226 family planning providers in WV to assess patterns of LARC availability. The survey assessed provider training level, LARC services provided and frequency, clinical practice, referral patterns, and comfort level providing adolescent LARC services. Survey results were analyzed by providers’ rural vs urban status, based on US census county codes. Survey responses …

Incidental Retroperitoneal Castleman’S Disease Found In Patient With Renal Cell Carcinoma: A Case Report, Samantha Richardson, James Jensen, Niru Nahar, Nadim Bou Zgheib

Marshall Journal of Medicine

This report briefly discusses a case of retroperitoneal Castleman’s disease in a 52 year old post-menopausal woman with renal cell carcinoma.

Group A Streptococcus Brain Abscess In A Patient On Adalimumab Therapy, Ryan Carroll, Ahmad Abu-Hashyeh, James Gainer, Kara Willenburg, Charles Meadows

Marshall Journal of Medicine

Brain abscesses represent a group of dangerous infections typically caused by a number of classic organisms. Group A Streptococcus is a rare cause of brain abscesses and those patients that do have this particular condition will typically have a distal source of infection. We present a case of patient with a biopsy confirmed Group A Streptococcal without a distal source of infection. His only identifiable risk factor was his adalimumab therapy for ankylosing spondylitis. While adalimumab has not been linked to Streptococcal infection in the past, it has been associated with multiple atypical infections and some of the consequences of …

The Challenge Of Electronic Cigarettes, Sutoidem Akpanudo

Marshall Journal of Medicine

No abstract provided.

Giving Hope: Best Healing Power In Medicine, Nadim Bou Zgheib

Marshall Journal of Medicine

No abstract provided.

Extending Our Reach: Looking To The Future For The Marshall Journal Of Medicine, Darshana T. Shah

Marshall Journal of Medicine

No abstract provided.

Procedural Memory Following Moderate-Severe Traumatic Brain Injury: Group Performance And Individual Differences On The Rotary Pursuit Task, Arianna Rigon, Nathaniel B. Klooster, Samantha Crooks, Melissa C. Duff

Communication Disorders Faculty Research

The impact of traumatic brain injury (TBI) on procedural memory has received significantly less attention than declarative memory. Although to date studies on procedural memory have yielded mixed findings, many rehabilitation protocols (e.g., errorless learning) rely on the procedural memory system, and assume that it is relatively intact. The aim of the current study was to determine whether individuals with TBI are impaired on a task of procedural memory as a group, and to examine the presence of individual differences in performance. We administered to a sample of 36 individuals with moderate-severe TBI and 40 healthy comparisons (HCs) the rotary …